Bachelor of Public Health team examines water insecurity among Haitian residents in new studies

By the time UF Bachelor of Public Health students Hannah Douglas and Andrew Fiore graduated this spring they had another achievement to add to the list — published author. Along with other members of a UF team, the students published a pair of research articles in the journal PLOS One on water insecurity among Haitian residents.

Hannah Douglas
Hannah Douglas

Based on surveys with 500 residents of urban and peri-urban areas in Haiti and in-depth interviews with 60 Haitian women, the research team published both a quantitative analysis and qualitative study on perceived water insecurity as well as impacts on women’s health. The papers have also been accepted for presentation at the annual conference of the American Public Health Association in November in Philadelphia where Fiore will discuss the findings during a roundtable discussion.

Publishing articles in a peer-reviewed journal as an undergraduate is an impressive feat, but in Douglas and Fiore’s case it is no surprise, said Bachelor of Public Health Director Elizabeth Wood, D.H.S., M.P.H.

“These students have been in my classes and advised by me since 2017, so they know my style and the expectations I have for students I work with,” said Wood, also a clinical assistant professor in the department of environmental and global health. “Saying that, both Andrew and Hannah are phenomenal and I would expect nothing short of each one being successful in their future endeavors.”

Andrew Fiore
Andrew Fiore

Douglas, who participated in the papers’ analysis and writing as part of her undergraduate honors thesis, was drawn to the project because of an interest in epidemiology and waterborne diseases.

“Haiti is so close to Florida — just one flight and a couple of hours away — but it is so different,” said Douglas, who is currently enrolled in UF’s accelerated Bachelor of Science in Nursing program.

“This was my first publication so I thought it was a great outcome of the program and not completely expected,” Douglas said.

Wood asked Fiore, who also earned a UF bachelor’s degree in statistics, to join the research team as the statistician.

“PHHP has a lot of research resources and mentorship opportunities that other colleges just don’t have,” said Fiore, whose career plans include attending medical school.

The team analyzed data from household water insecurity experience surveys of residents in Gressier, Haiti, a peri-urban community, and Léogâne, an urban area. Kelly Chapman, a UF doctoral student in anthropology, collected data from March to May 2018 and was joined in the effort in May by eight undergraduate students participating in UF’s first study abroad program to Haiti. Three local Haitian staff worked as translators. Following collection of the surveys, selected participants were contacted again and asked to participate in in-depth interviews.

Haiti hand pump
A resident of Léogâne uses a hand pump installed by a non-governmental organization. Photo by Dr. Jocelyn Widmer.

The quantitative analysis of the surveys revealed significant differences in water costs and water sources between the two communities. The team also identified household and behavioral characteristics associated with water insecurity, such as larger family size or experiencing an injury during water collection.

“As we were modeling data associated with increased water insecurity you could piece together a story where a woman who was the sole provider of water for her family was injured while she was collecting water,” Fiore said. “That may happen by slipping and falling or a bad actor at a neighborhood well who was causing injury to people trying to get water.”

Through the qualitative analysis study, the team was able to validate rumors and anecdotes around the cultural and normative beliefs surrounding water, water types and infections that can arise from water, Wood said. These included the misconception that engaging in sexual intercourse in saltwater will not result in pregnancy.

“I hope these findings will help public health practitioners target future interventions, including education on water safety and health for women, as well as boosting community morale so people will work together toward great water accessibility,” Douglas said.

In addition to Douglas, Fiore, Wood and Chapman, research team members included Meredith Nappy, academic assistant in the Bachelor of Public Health program, and Robinson Bernier, a Haitian enumerator working alongside the team in Haiti.